Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-7473

Government Authority located in Texas; USA based organization looking for expert vendor for third party administrative services.

[*] Budget: Looking for Proposals

[*] Scope of Service:

(1) Vendor needs to provide third party administrative services.
-  Health care administration (claims processing, network management, utilization review and other services) for Plans.
- The consumer directed health select plan is a high-deductible health plan provided under a self-funded basis paired with a health savings account.
- Legal Requirements and Regulatory Compliance
- Plan Design, Eligibility, Benefits and Program:
- All preauthorization and cost containment activities are provider-initiated.
- Except for required copayments, coinsurance, deductibles, and ineligible charges, network providers shall not balance bill any Participant.
- Participants are not required to submit claim forms when care is rendered through a network provider.
- Support integrated, efficient and effective systems of care, delivery and payment
- Promote a patient-centered approach to service delivery and payment
- Provide greater efficiencies with opportunities to reduce or eliminate provider costs
- Support payment and processes that are transparent, easy to understand, and simple to administer for Participants, providers, purchasers and other stakeholders
- Provide and maintain a network that offers broad access and minimal disruption, as compared to the current network.
- Primary focus in its web page design is to provide information about the Plans.
(2) The contract period will be for six years.  

[*] Eligibility:

- Onshore (USA Organization Only);

[*] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office location.

Expiry Date : Thursday, 8 June, 2023

Category : Medical Billing and Coding

Country : USA

State : Texas

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